Vestibular disorders: persistent postural-perceptual dizziness: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Vestibular disorders: persistent postural-perceptual dizziness

Sample item

Six months after recovery from vestibular neuritis, a woman has constant unsteadiness and non-spinning dizziness that worsens when standing, in busy supermarkets and with scrolling screens. Neurological examination, caloric tests and imaging are normal. What is the most likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Persistent postural-perceptual dizziness

Persistent postural-perceptual dizziness (PPPD) is a chronic functional vestibular disorder, often triggered by an acute vestibular event. Symptoms last more than three months, are worse upright and with visual motion or complex scenes, and tests are normal. Treatment is vestibular rehabilitation, cognitive behavioural therapy and SSRIs or SNRIs.

Option by option

  • A. Residual vestibular neuritis with ongoing deficit

    A residual neuritis deficit would be shown by abnormal caloric or head-impulse tests.

  • B. Meniere disease

    Meniere disease gives episodic vertigo with fluctuating hearing loss and tinnitus.

  • C. Persistent postural-perceptual dizziness (correct)

    Correct. Chronic non-spinning dizziness provoked by upright posture and visual motion after a triggering event fits PPPD.

  • D. Posterior canal BPPV

    BPPV gives brief positional spinning episodes with a positive manoeuvre.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this ENT question

What is the answer to this ENT question?

The best answer is C, Persistent postural-perceptual dizziness. Persistent postural-perceptual dizziness (PPPD) is a chronic functional vestibular disorder, often triggered by an acute vestibular event.

Why is "Residual vestibular neuritis with ongoing deficit" not the answer?

A residual neuritis deficit would be shown by abnormal caloric or head-impulse tests.

Why is "Meniere disease" not the answer?

Meniere disease gives episodic vertigo with fluctuating hearing loss and tinnitus.

Why is "Posterior canal BPPV" not the answer?

BPPV gives brief positional spinning episodes with a positive manoeuvre.

What concept does this question test?

It tests Vestibular disorders: persistent postural-perceptual dizziness in ENT. Symptoms last more than three months, are worse upright and with visual motion or complex scenes, and tests are normal. Treatment is vestibular rehabilitation, cognitive behavioural therapy and SSRIs or SNRIs.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Vestibular disorders: persistent postural-perceptual dizziness?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.